Trocar-site incisional hernia after 8-mm robotic trocar placement: A prospective study.

Autor: Cianfarani A; Department of Surgery, Lugano Regional Hospital, EOC, Lugano, Switzerland.; Department of Surgery, Bellinzona e Valli Regional Hospital, EOC, Bellinzona, Switzerland., Mongelli F; Department of Surgery, Bellinzona e Valli Regional Hospital, EOC, Bellinzona, Switzerland.; Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland., Iaquinandi F; Department of Surgery, Bellinzona e Valli Regional Hospital, EOC, Bellinzona, Switzerland., Xhepa G; Department of Surgery, Bellinzona e Valli Regional Hospital, EOC, Bellinzona, Switzerland., Pini R; Department of Surgery, Bellinzona e Valli Regional Hospital, EOC, Bellinzona, Switzerland., Gaffuri P; Department of Surgery, Bellinzona e Valli Regional Hospital, EOC, Bellinzona, Switzerland., La Regina D; Department of Surgery, Bellinzona e Valli Regional Hospital, EOC, Bellinzona, Switzerland.; Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland.
Jazyk: angličtina
Zdroj: World journal of surgery [World J Surg] 2024 Jul; Vol. 48 (7), pp. 1656-1661. Date of Electronic Publication: 2024 May 14.
DOI: 10.1002/wjs.12214
Abstrakt: Background: The current literature supports the closure of trocar sites ≥10-mm for the risk of developing incisional hernias, while there is no need to suture the abdominal fascia when using 5-mm trocars. To date, evidence regarding the closure of 8-mm trocars that are use by new robotic systems is weak. The aim of our study was to investigate the incidence of incisional hernia for 8-mm trocars.
Methods: We prospectively collected data on all patients undergoing robotic-assisted abdominal wall surgery from 2020 to 2023, in whom the abdominal fascia of all 8-mm trocars was not closed. The enrolled patients underwent a follow-up visit during which we conducted clinical and sonographic evaluations of all 8-mm trocars, in addition to assessing the satisfaction levels of the patients. The primary outcome was the incidence of port-site hernia.
Results: We enrolled 166 patients, 155 men and 11 women, for a total of 513 trocars accessed. Mean age was 61.1 ± 14.0 years, and mean BMI was 27.0 ± 3.9 kg/m 2 . The follow-up visits were carried out after a median follow-up of 14.5 (9.0-23.2) months. Only one case developed an asymptomatic 1 × 1 cm supra-umbilical hernia that was not treated. Patient reported a satisfaction regarding the 8-mm trocars and skin sutures of 9.8 ± 0.5 out of 10 points.
Conclusions: The occurrence of a trocar-site hernia after 8-mm robotic access is extremely low. Hence, the fascia closure may not be necessary.
(© 2024 International Society of Surgery/Société Internationale de Chirurgie (ISS/SIC).)
Databáze: MEDLINE
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